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National CooperativeRx is pleased to announce MedImpact as an additional PBM option.
This historic addition reflects the Cooperative’s ongoing commitment to expand our offerings to respond to market conditions and serve plan sponsors. As the pharmacy benefits landscape continues to evolve, a one-size-fits-all approach cannot meet every plan sponsor’s needs. The addition of MedImpact expands the Cooperative’s ability to support diverse benefit strategies and gives plan sponsors greater flexibility to choose the PBM partner that best fits their organization’s goals.
The Role of National CooperativeRx
Since 2003, National CooperativeRx has identified, negotiated, and governed a best-in-class PBM arrangement for our members—securing a competitive master PBM contract and enforcing accountability and contractual commitments. Our value-added services, including independent audits, clinical oversight, and industry navigation, control pharmacy spend and improve outcomes.
Historically, the Cooperative’s strategy has centered on a single PBM partner, CVS Caremark, with whom we’ve achieved significant membership growth and strong results for our membership. However, as the needs of plan sponsors have evolved, the request for additional options has increased.
Listening to Plan Sponsors and Partners
Rising costs, vertical integration, PBM consolidation, evolving clinical needs, and fiduciary expectations are among the major drivers prompting plan sponsors to reevaluate their pharmacy benefit strategies.
Through conversations with our members and prospective groups, several common requests have emerged, including:
- Competitive pass-through pricing
- Alternative PBMs outside of the “Big 3”
- Quicker responses to market changes
- Ability to integrate savings solutions from outside of the PBM
This feedback led to a multi-year effort to expand our PBM portfolio to address these requests with a competitive PBM solution.
The Process of Selecting MedImpact
Selecting an additional PBM partner wasn’t a decision we made lightly. We conducted a comprehensive request for proposal (RFP) process with an outside PBM expert, evaluating multiple PBMs across a wide range of criteria, including:
- Financial performance and pricing transparency
- Clinical programs and member outcomes
- Customer service and account management
- Technology and reporting capabilities
- Formulary management
- Implementation support
- Regulatory compliance
- Flexibility
- Market reputation and long-term stability
Following our evaluation, we selected MedImpact due to several differentiators, including:
- 100% pass-through pricing model
- Being the largest independent health solutions and pharmacy benefit company
- Quick adaptation to evolving consumer needs as a mid-size model
- Ability to accommodate popular market solutions with guardrails
- Flexible pharmacy benefit designs
- Full transparency into master contract and compensation
- Guaranteed pricing
Our evaluation wasn’t about finding another PBM—it was about finding a viable solution to provide our members with more options to navigate the complex prescription drug marketplace.
While other PBM options exist, we identified those as smaller organizations that lacked the purchasing power to secure competitive pricing. Additionally, transparency and ownership concerns left us uncertain whether those options could remain fully aligned with plan sponsors’ financial interests. Lastly, we needed a long-term solution that could sustain market developments and maintain regulatory compliance.
After careful evaluation, MedImpact emerged as a strong strategic fit that complements National CooperativeRx’s model and will provide meaningful value to our membership.
Two PBM Pathways: CVS Caremark and MedImpact
Our role is not to resell a PBM. We curate, operationalize, and govern PBM operating models, so plan sponsors can choose the pathway that best fits their needs.
Each pathway operates under a single master contract that National CooperativeRx negotiates and manages on behalf of all participating plans.
Some plan sponsors value the familiarity and breadth of a large platform, such as our CVS Caremark arrangement. This traditional pricing model offers a large-scale PBM experience.
Some plan sponsors value operating flexibility and autonomy, such as our MedImpact arrangement. This pass-through pricing model offers a mid-size PBM experience with a more transparent economic structure.
Regardless of the pathway chosen, National CooperativeRx enforces contractual protections, robust audit capabilities, clinical oversight, and operational performance accountability. These are key for plan sponsors looking to comply with their fiduciary duties.
Determining the Best Fit for Plan Sponsor Needs
To determine whether our MedImpact arrangement is a fit, we encourage plan sponsors to consider:
- How a pass-through pricing structure will compare to a traditional pricing structure
- Whether tighter management aligns with the plan’s desired level of control
- Willingness to accept higher levels of plan participant “noise” in exchange for lower spend
A MedImpact repricing analysis may be requested through a National CooperativeRx representative. If, after the analysis has been reviewed and all questions have been addressed, the plan sponsor chooses to transition to our MedImpact arrangement, our team will manage implementation with MedImpact and collaborate with plan sponsors and their broker/consultant partners to ensure a smooth onboarding process. Implementation requires at least 90 days.
National CooperativeRx: More Optionality, Same Trusted Cooperative
National CooperativeRx is pleased to maintain our successful longstanding partnership with CVS Caremark, which remains a viable option for both current and prospective members.
With two distinct PBM pathways now available, the Cooperative is positioned to help more plan sponsors align their pharmacy benefits strategy with their financial and clinical priorities.
While the PBM pathways differ, the Cooperative’s role remains constant. National CooperativeRx will continue to govern and actively oversee performance and contractual accountability, in the best interest of our membership.
Our expanded approach delivers choice to plan sponsors, without compromising the governance, expertise, or oversight that define the Cooperative model.
Interested in Learning More?
Please reach out to your National CooperativeRx representative to learn more about our offerings or contact us here.
